Latest Research in Nail Psoriasis

Pasch, Marcel C.; Iorizzo, Matilde

doi:10.1007/978-3-030-59997-3_12

Cited by 2 publications

(1 citation statement)

References 218 publications

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“…Psoriasis does not only affect the skin but also the nails, the joints and the entheses 1 , 2 . Nail psoriasis is a condition that is associated with a more severe disease, loss of quality of life and progress to psoriatic arthritis (PsA) 3 , 4 . Thus, in order to adapt the therapy of patients adequately and in a timely manner, quantifying the current extent of nail psoriasis as well as its progress over time is highly desirable.…”

Section: Introductionmentioning

confidence: 99%

DeepNAPSI multi-reader nail psoriasis prediction using deep learning

Folle

Fenzl

Fagni

et al. 2023

Sci Rep

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Nail psoriasis occurs in about every second psoriasis patient. Both, finger and toe nails can be affected and also severely destroyed. Furthermore, nail psoriasis is associated with a more severe course of the disease and the development of psoriatic arthritis. User independent quantification of nail psoriasis, however, is challenging due to the heterogeneous involvement of matrix and nail bed. For this purpose, the nail psoriasis severity index (NAPSI) has been developed. Experts grade pathological changes of each nail of the patient leading to a maximum score of 80 for all nails of the hands. Application in clinical practice, however, is not feasible due to the time-intensive manual grading process especially if more nails are involved. In this work we aimed to automatically quantify the modified NAPSI (mNAPSI) of patients using neuronal networks retrospectively. First, we performed photographs of the hands of patients with psoriasis, psoriatic arthritis, and rheumatoid arthritis. In a second step, we collected and annotated the mNAPSI scores of 1154 nail photos. Followingly, we extracted each nail automatically using an automatic key-point-detection system. The agreement among the three readers with a Cronbach’s alpha of 94% was very high. With the nail images individually available, we trained a transformer-based neural network (BEiT) to predict the mNAPSI score. The network reached a good performance with an area-under-receiver-operator-curve of 88% and an area-under precision-recall-curve (PR-AUC) of 63%. We could compare the results with the human annotations and achieved a very high positive Pearson correlation of 90% by aggregating the predictions of the network on the test set to the patient-level. Lastly, we provided open access to the whole system enabling the use of the mNAPSI in clinical practice.

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